Prognostic Indicators and Treatment Strategies for Diffuse Midline Glioma: a Systematic Review

Abstract

IntroductionDiffuse Midline Gliomas (DMGs) are a class of grade IV gliomas associated with a very dismal prognosis. Despite many decades of research, a cure for DMG has yet to be found. In this paper, we will review the drugs and therapeutic techniques published in the scientific literature for DMG.MethodsA comprehensive search of current literature was conducted in MEDLINE/PubMed. Relevant studies were identified among those in the English language published after 1990 to the present. The Medical Subject Headings (MeSH) search term consisted of the singular phrase “diffuse midline glioma”. Prior to completion of the full-text review, a total of 298 articles were identified as of 26 April 2021. For this systematic review, 20 studies were included after review.ResultsRecent genetic testing has identified a H3K27M mutation that is characteristic of DMGs. This finding has helped pave the way in developing new therapeutic agents and techniques for DMG. Although these newer drugs and therapeutic modalities have not been shown to cure DMG, some of them have been shown to increase overall survival and reduce symptom severity in select patients.ConclusionsAt this point in time, there is no best treatment agent/modality for patients with DMG; rather, the treatment plan should be tailored to the patient’s specific type of DMG. More research is needed to develop better therapeutics and provide improved outcomes to patients.